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W.F. Schrader, S. Beisel, C.N. Keilhauer; Three Years Results of Photodynamic Therapy in Age Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):351.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the long term development of patients that received photodynamic therapy for age related macular degeneration. We use photodynamic therapy (PDT) for chororidal neovascularization (CNV) in age related macular degeneration (ARMD) now for 5 years. Only few long term results with a follow up of 3 years or more have been published so far.
Patients and Methods: :
retrospective analysis; among 198 consecutively treated cases with a follow up of at least one year, 102 cases had a minimal follow up of 30 months. Baseline characteristics (Type of CNV, history of visual decrease, iris colour, smoking habits) were not different between the main group and the subgroup, that could be followed at least for 30 months.
Mean follow up of the 102 cases was 39.01 months. 25 patients (25%) received one PDT, 32 (31%) 2 PDTs, 24 (24%) 3 PDTs and 21 (21%) more than 3 PDTs. Visual acuity (VA) stabilised within 3 lines in 30 patients (35%), 3 patients (3%) at least doubled in vision. 63 patients (62%) had a decrease of VA of more than 3 lines. Patients with a >80% classic CNV stabilized or ameliorated VA in 41% (17/42), a drop of 3 lines or more occurred in 59% (25/42) of these patients. The treated eye was the better eye in 33 cases at baseline and in 23 cases after 3 years. PDT helped to stabilize a reading ability with a VA of 20/50 or better in 48% (49/102) in the better eye. With enlarging devices, reading ability could be preserved in another 29% (VA of 20/200 to 20/60), legal blindness (VA <20/200 in the better eye) occurred in 23 cases (23%).
We did not meet the results of the TAP Studies. Also, a >80% classic CNV had nor better results than a predominantly (>50%) classic CNV. Although the mean visual acuity deteriorated in the treated eye by 4 lines over 3 years, PDT for subfoveal CNV in ARMD helped to stabilize VA in 39% of our cases. At baseline, a patient eligible for PDT had a 77% chance to preserve reading ability over 3 years, either with simple reading glasses or with enlarging devices.
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